[HSF] [Fwd: Re: ccml Quiz for Christmas]

[prasannasimha]

No.
The curve was  showing a CVP trace with a prominent X descent suggestive 
of either early tamponade or a dilated RV "restricted by the chest wall 
/ pericardium. There was simultaneous increased delta dip showing a 
decrease in LV preload despite a CVP of 11 (volume loading was initially 
tried) as the RV was not "sending" volume to the left side adequately.
Echo showed do diastolic collapse and RV dysfunction and was managed by 
increasing support for the next 6 hours and was weaned off after the X 
descent disappeared. Incidentally the chest tubes were removed as hey 
were not draining and removal gave a little more "space " for the RV.
V. Aldrete, M.D. wrote:
> Hi Prasanna,
>
> Did you have a drainage catether across the PA obstructing pulmonary 
> flow?
>
> Victor
> On Dec 25, 2006, at 4:56 AM, prasannasimha wrote:
>
>> Part2 of the same quiz
>>
>>
>>
>> Same case next day morning. Stable and off inotropes prior to removal 
>> of lines.
>> Prasanna
>>
>>
>>
>>
>> <quiz26answerfollowup.jpg>
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